The paper titled Ethical issues in dialysis therapy argues that health systems should establish programmes of kidney disease prevention and health promotion in conjunction with dialysis and transplantation programmes.
Efforts to provide affordable dialysis to those with end- stage kidney disease should be done in conjunction with more cost-effective efforts to prevent its development using proven methodologies, argues a new paper published in the Lancet on Friday.
The paper titled Ethical issues in dialysis therapy argues that health systems should establish programmes of kidney disease prevention and health promotion in conjunction with dialysis and transplantation programmes. It also argues that health professionals and policy makers should strive to reduce the costs of dialysis, using simple, safe and affordable modalities without compromising on the quality of therapy provided to the patients.
“The aim of equitable access to renal replacement therapy and best practice care for all patients with end-stage kidney disease presents major ethical, practical and economic challenges for health-care systems. These challenges include increasing access to dialysis, helping patients and families to make the best decisions about management of advanced kidney failure and ensure that patients receive affordable high quality chronic dialysis that is based on standards accepted worldwide,” said Dr. Vivekanand Jha, Executive Director of the George Institute for Global Health, India and the lead author of the paper.
About 2.2 lakh new patients of end-stage renal disease get added in India every year resulting in additional demand for 3.4 crore dialysis sessions. With approximately 4,950 dialysis centres in India, largely in the private sector and concentrated in major towns, the demand is only half met. Every dialysis session costs about Rs 2,000 — an annual expenditure of more than Rs 3 lakh. Besides, most families have to undertake frequent trips, often over long distances, to access dialysis services, incurring heavy travel costs and loss of wages.
To address the situation, the centre in 2016 proposed to start a ‘National Dialysis Services Programme’ under the National Health Mission under Public-Private Partnership (PPP) model, to provide dialysis services in all district hospitals. To reduce the cost, the government proposed to exempt certain parts of dialysis equipment from basic customs duty, excise/ Countervailing Duty (charged under import) and Special Additional Duty.
“Audit systems should be designed to facilitate and encourage documentation of patient care and transparent reporting of costs and outcomes of care to provide an evidence base for decision making and objective evaluation of performance,” he said.
The paper also points out that access criteria and policy must be informed by an understanding of broader access issues relating to prevention and management of chronic kidney disease, supportive care, management of co-morbidities and complications, and general health-care services.
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
 "patients")
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
)
){kind=small}
){kind=small}
)
)
)
)
)
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}